Patient Passport Research Articles

P244 Development Of A Tailor-Made Implementation Strategy To Facilitate Adherence To The Dutch Postpartum Hemorrhage Guideline And Moet-Instructions

BackgroundDespite the introduction of a national guideline and the Managing Obstetric Emergencies and Trauma (MOET) course the incidence of postpartum haemorrhage (PPH) is increasing. We suspected inadequate guideline implementation to...

One-page patient passport for people with learning disabilities

People with learning disabilities can have negative experiences in hospitals. One of the key reasons for this is the lack of time available for staff to understand individuals' needs. This article describes the development and implementation of the one-page patient passport, designed to provide individualised information about the person for doctors, nurses and administrative staff. The results from a pilot evaluation indicate that the tool promotes high levels of support for people with learning disabilities on admission to and during their stay in hospital.

One-page patient passport for people with learning disabilities.

One-page patient passport for people with learning disabilities.

Co-payment for medical treatment

In 2004, the then Minister of State for Health in the UK, John Hutton, stated: ‘We strongly believe that the introduction of vouchers, passports, co-payment, or extra charges to patients will have a regressive impact on the health of our people – as all of the international evidence confirms. That is why a patient's passport to personal health should not be dependent on a patient's personal wealth.’1 This unequivocal position now appears to be less secure in 2008 due to a number of factors including: The continued increase in the number of innovative (but expensive) treatments available in the health-care market; Several high-profile challenges to decisions by the National Institute of Health and Clinical Excellence (NICE) with regard to funding for new treatments, for example drugs for Alzheimer's disease and certain forms of cancer;2,3 Specific case reports precipitating a public debate about the permissibility of patients paying for treatments not funded by the National Health Service (NHS) as part of their NHS care.4 The specific issue of co-payment for drugs not funded by the NHS is now the subject of a Government-commissioned review of policy in this area, chaired by Professor Mike Richards and expected to report in October 2008. The ethical dilemmas raised by requests from patients to be able to pay for a treatment currently not funded by the NHS but which the patient and clinician consider a desirable treatment option have been discussed previously in this journal and elsewhere.5,6 It is also a problem that is brought to clinical ethics committees and one which challenges us to reflect on the core values of the NHS. In this FMF we will consider the ethical values and arguments underpinning the debate.

Self-Management for People with Inflammatory Bowel Disease

In North America and the United Kingdom, we are in the age of self-management. Many patients with chronic diseases are ready to participate in the therapeutic decision-making process, and join their physicians in a co-management model. It is particularly useful to consider this concept at a time when physician shortages and waiting times are on the front page every day, with no immediate prospect of relief. Conditions such as diabetes, asthma, chronic obstructive pulmonary disease, recurrent urinary tract infections and others lend themselves to this paradigm of medical care for the informed patient. The present paper reviews some of the literature on self-management for the patient with inflammatory bowel disease (IBD), and provides a framework for the use of self-management in the IBD population, with emphasis on the concept of a patient passport, and the use of e-mail, supported by an e-mail contract, as proposed by the Canadian Medical Protective Association. Examples of specific management strategies are provided for several different IBD scenarios. Eliminating the need for some office visits has clear environmental and economical benefits. Potential negative consequences of this form of patient care are also discussed.

To choose the Right of ‘The Right To Choose'?

As a leader, Iain Duncan Smith didn't leave the Conservative Party much of a legacy. OK, they knew where they stood on Europe – firmly outside, thank you very much. There was a brief concern, launched on the Easterhouse council estate in Scotland, for the poor and the dispossessed. In health terms, Duncan Smith and his health spokesman Dr Liam Fox gave us the Patient's Passport: a subsidy to those who use private health surgery of 50% of the NHS cost of their operation.